14842 Health Library | Health and Wellness | Wellmont Health System
  • Melanoma Removal

    Definition

    Melanoma removal is a surgery to remove skin tissue that has cancerous cells. The cancer is called melanoma.
    Melanoma
    Melanoma
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    Reasons for Procedure

    A melanoma removal is done to treat melanoma skin cancer.

    Possible Complications

    Complications are rare, but no procedure is completely free of risk. If you are planning to have melanoma removal, your doctor will review a list of possible complications, which may include:
    • Infection
    • Bleeding
    • Incomplete removal of all cancerous cells
    • Recurrence or spread of cancer
    • Nerve damage
    • Scarring
    Factors that may increase the risk of complications include:

    What to Expect

    Prior to Procedure

    Depending on the stage of the disease, your doctor will likely do the following:
    • Physical exam of skin
    • Biopsy of any suspicious lesion
    • Chest x-ray—uses radiation to take a picture of the chest
    • Blood tests
    • Imaging studies with CT scan, MRI, or PET scan
    • Sentinel lymph node biopsy—to find out if the cancer has spread

    Anesthesia

    Local anesthesia is often used to numb the area where the cancer is removed. General anesthesia may need to be used if the area is large. In this case, you will be asleep.

    Description of the Procedure

    Surgical removal of the cancerous cells is the primary treatment for melanoma. Types of surgery include:
    • Simple excision—Thin melanomas can usually be completely cured with this relatively minor surgery. The tumor is cut out, along with a small amount of normal, noncancerous skin at the edges. The wound is stitched back together and usually leaves a scar.
    • Wide excision—More skin is cut away from the site to make sure no cancer cells remain in the skin.
    • Amputation—If melanoma is present on a finger or toe, it may be necessary to cut off the cancerous part of that digit.
    • Lymph node dissection—If the cancer has spread to nearby lymph nodes, some of those nodes will be surgically removed for laboratory exam.
    Depending on how extensive the melanoma removal proves to be, the area may be closed with stitches or may require a skin graft for repair. Stitches will be removed about 7-14 days after surgery, depending on the site and extent of excision.

    After Procedure

    The removed tissue will be examined by a laboratory.
    In more advanced cases of melanoma, other treatments may be necessary. These include:
    • Chemotherapy (using drugs to kill cancer cells)
    • Radiation therapy (using radiation to kill cancer cells)
    • Immunotherapy (which uses the body's immune system to kill cancer cells)
    • Biological therapy (such as gene therapy, tumor vaccines, or monoclonal antibodies)

    How Long Will It Take?

    This depends on the extent of the melanoma and the type of surgery. Simple excision can take less than one hour.

    Will It Hurt?

    Anesthesia prevents pain during the procedure. You may have some pain around the wound during recovery. You will be given medicine to help manage pain.

    Postoperative Care

    • Keep the surgical area clean, dry, and protected by bandages. Wash it gently with mild soap.
    • If recommended by your doctor, apply a nonprescription antibiotic ointment to the wound before applying bandages.
    • If prescribed, take pain medicine and antibiotics.
    • Avoid vigorous exercise according to your doctor's recommendations.
    • Return to have any stitches or staples removed when instructed.
    Talk to your doctor about appropriate ways to protect your skin against sun damage. These may include using sun block and wearing protective clothing. Ask your doctor about when it is safe to shower, bathe, or soak in water. You will also need to have regular skin exams to look for the return of cancer cells. Do self-exams to look for any new or changing moles. Your doctor can show you how to do a self-exam.

    Call Your Doctor

    After arriving home, contact your doctor if any of the following occur:
    • Signs of infection, including fever and chills
    • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
    • Pain that you cannot control with the medicines you have been given
    • A new lump or discoloration in your skin, or a change (such as color, bleeding, itching, or growth) in an already-existing mole, either at the surgical site or in a new location
    • Any other new or concerning symptoms
    In case of an emergency, call for medical help right away.

    RESOURCES

    American Academy of Dermatology http://www.aad.org/default.htm

    American Cancer Society http://www.cancer.org

    CANADIAN RESOURCES

    Canadian Cancer Society http://www.cancer.ca

    Canadian Society of Plastic Surgery http://www.plasticsurgery.ca

    References

    American Cancer Society website. Available at: http://www.cancer.org.

    American Society for Dermatologic Surgery website. Available at: http://www.asds-net.org.

    Balch CM, Buzaid AC, Soong SJ, et al. Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. Guidelines from the American Joint Committee on Cancer. J Clin Oncol. 2001;19:3635-48.

    Lens MB, Dawes M, Goodacre T, Bishop JA. Excision margins in the treatment of primary cutaneous melanoma: a systematic review of randomized controlled trials comparing narrow vs. wide excision. Arch Surg. 2002;137:1101-5.

    National Cancer Institute website. Available at: http://www.cancer.gov.

    Physician quality reporting system 2011 quality measures. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com. Updated January 5, 2011. Accessed October 20, 2011.

    6/2/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

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